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Meta-Analysis
. 2020 Nov;29(11):105185.
doi: 10.1016/j.jstrokecerebrovasdis.2020.105185. Epub 2020 Jul 22.

Impact of the Coronavirus Disease Pandemic on the Number of Strokes and Mechanical Thrombectomies: A Systematic Review and Meta-Analysis

Julius July  1 , Raymond Pranata  2
Affiliations
Meta-Analysis

Impact of the Coronavirus Disease Pandemic on the Number of Strokes and Mechanical Thrombectomies: A Systematic Review and Meta-Analysis

Julius July et al. J Stroke Cerebrovasc Dis. 2020 Nov.

Abstract

Background: This systematic review and meta-analysis aimed to evaluate the impact of the coronavirus disease (COVID-19) pandemic on stroke care, including the number of stroke alerts/codes, number of reperfusions, and number of thrombectomies during the pandemic compared to those during the pre-pandemic period.

Methods: A systematic literature search was performed using the PubMed, EuropePMC, and Cochrane Central databases. The data of interest were the number of strokes, reperfusions, and mechanical thrombectomies during the COVID-19 pandemic versus that during the pre-pandemic period (in a historical comparator group over a specified period of same period length).

Results: The study included 59,233 subjects from 9 studies. Meta-analysis showed that the number of stroke alerts during the pandemic was 64% (56-71%) of that during the pre-pandemic period. The number of reperfusion therapies during the pandemic was 69% (61-77%) of that during the pre-pandemic period. Pooled analysis showed that the number of mechanical thrombectomies performed during the pandemic was 78% (75-80%) of that during the pre-pandemic period. The number of mechanical thrombectomies per stroke patient was higher during the pandemic (OR 1.23 [1.12-1.36], p < 0.001; I2: 0%, p = 0.845).

Conclusion: This meta-analysis showed that the number of stroke alerts, reperfusions, and mechanical thrombectomies was reduced by 36%, 31%, and 22%, respectively, during the pandemic. However, the number of patients receiving mechanical thrombectomy per stroke increased.

Keywords: COVID-19; Cerebrovascular Diseases; Mechanical Thrombectomy; SARS-CoV-2; Stroke.

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Figures

Fig 1
Fig. 1
Study flow diagram.
Fig 2
Fig. 2
Forest plot showing the number of stroke alerts/codes during the pandemic compared with the pre-pandemic period.
Fig 3
Fig. 3
Forest plot showing the number of reperfusion therapies during the pandemic compared with the pre-pandemic period.
Fig 4
Fig. 4
Forest plot showing the number of mechanical thrombectomies during the pandemic compared with the pre-pandemic period
See this image and copyright information in PMC

References

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